Provider Demographics
NPI:1568650075
Name:OKLAHOMA MEDICAL SOLUTIONS, LLC
Entity Type:Organization
Organization Name:OKLAHOMA MEDICAL SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER / MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CARL
Authorized Official - Middle Name:A
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:COTA/L
Authorized Official - Phone:405-609-7566
Mailing Address - Street 1:2316 SANTA FE TER
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73012-4450
Mailing Address - Country:US
Mailing Address - Phone:405-609-7566
Mailing Address - Fax:405-330-4846
Practice Address - Street 1:2316 SANTA FE TER
Practice Address - Street 2:
Practice Address - City:EDMOND
Practice Address - State:OK
Practice Address - Zip Code:73012-4450
Practice Address - Country:US
Practice Address - Phone:405-609-7566
Practice Address - Fax:405-330-4846
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies